Is eGFR >= 60 mL/min/1.73 m(2) in Patients Undergoing Coronary Angiography Really Safe for Contrast Nephropathy?

ANGIOLOGY(2023)

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Abstract
The aim of the present study was to define the risk factors associated with contrast-induced acute kidney injury (CI-AKI) in patients who underwent coronary artery angiography (CAG). In this retrospective cohort study, patients who underwent CAG between March 2014 and January 2022 were evaluated. A total of 2923 eligible patients were included in the study. Univariate and multivariate logistic regression analysis was used to identify the predictive factors. CI-AKI developed in 77 (2.6%) of 2923 patients. In multivariate analysis, diabetes mellitus (DM), chronic kidney disease (CKD), and estimated glomerular filtration rate (eGFR) were found to be independent factors associated with CI-AKI. In the subgroup analysis of patients with eGFR >= 60 mL/min/1.73 m(2), eGFR remained a predictor of CI-AKI (Odds ratio (OR): .89, 95% CI: .84-.93; that is, a lower eGFR remains a risk factor for CI-AKI). In the receiving operating characteristic (ROC) analysis of patients with eGFR >= 60 mL/min/1.73 m(2), the area under the curve of the eGFR was .826. Using the ROC curve based on Youden's index, the eGFR cut-off was found to be 70 mL/min/1.73 m(2) for patients with eGFR >= 60 mL/min/1.73 m(2). eGFR is also an important risk factor in patients with eGFR 60-70 mL/min/1.73 m(2).
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Key words
acute coronary syndrome, contrast-induced acute kidney injury, coronary angiography
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